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May 2016
ARC Wilderness and Remote First Aid [WaRFA] Instructor Training at SOAR

Venturing Crew 9-1-1 and the American Red Cross of Conroe, Texas conducted a Wilderness and Remote First Aid [WaRFA] Basic and Instructor Training Class at the Steve Fossett Spirit of Adventure Ranch [SOAR] of Western Colorado Council near Dotsero, Colorado on June 30 through July 3, 2015.

WaRFA was developed through a joint BSA and American Red Cross partnership that developed standards-based certification programs to train youth and adults in backcountry emergency care techniques. Thousands of Scouts and leaders participate in backcountry high adventure annually and are routinely exposed to intrinsically hazardous environments due to natural hazards, trauma and medical risks that may occur where no emergency health care responders are quickly accessible or immediately available.  www.scouting.org/scoutsource/HealthandSafety/Training/wilderness_fa.aspx

WHY AMERICAN RED CROSS WaRFA TRAINING?
WaRFA classes are not widely available or easily accessed in many local Scout Councils.  Moreover, some private for-profit WFA provider courses are often expensive and thus may exclude some who cannot afford the fees.  The BSA-ARC agreement was designed to overcome those issues by making basic WaRFA courses open to age 14+ youth and to adults.  To strategically proliferate WaRFA training that is both inexpensive and widely available for youth and adults, the concept provides for training Venturers, Sea Scouts, Explorers who are age 16+ and adult leaders as certified ARC WaRFA instructors that can serve their own units, districts and councils with frequent or on-demand WaRFA training courses.

Crew 9-1-1 has begun an outreach program whereby they will travel to local councils with no established WaRFA instruct [as was done in Western Colorado Council in 2015] to provide both basic and instructor training programs that then become an effective solution in providing WaRFA training in the council.

Crew 9-1-1 Advisor, American Red Cross volunteer Instructor-Trainer and founder of the NBO Scout Training Team Jay Walker and his Staff trained and certified 19 instructor candidates including SOAR Sea Scouts, Venturers [age 16+] and adult Scouters as American Red Cross WaRFA Instructors during the four-day program.

Instructor-candidates then trained 11 students in WaRFA basic first aid.  The training is largely based on realistic scenario-based simulations emulating actual wilderness medical emergency situations which included [but were not limited to] severe trauma including head and spinal injuries, internal injuries, severe bleeding, fractures, burns, impaled objects, tension pneumothorax, as well as simulation of life-threatening medical emergencies such as cardiac arrest from heart attack or lightning strike, drowning, anaphylactic shock resulting from insect stings or food allergies, hypoglycemia [low blood sugar], and much more.

Crew 9-1-1 has trained thousands of Scouts, Venturers, Sea Scouts and Explorers in WaRFA basic and Instructor training, as well as Emergency Medical Response, Lifeguarding, Water Safety and other standards-based certificated Red Cross courses.

EMPOWERING YOUTH AS WaRFA INSTRUCTORS
A unique feature of Crew 9-1-1's outstanding and nationally recognized program is training older Scouts, Venturers, Sea Scouts and Explorers [age 16+] as instructors who are then authorized to teach and certify other youth and adults in WaRFA and other programs.  WaRFA-trained youth and instructors are often called upon to serve in actual emergency medical response capacities such as mass events [e.g., marathons, sports events, conventions, disasters and much more].  Many youth who have been certified also find career choices or avocational interests, and in later years have become physicians, nurses, paramedics, firefighters, law enforcement officers, and health care providers.


Moulage for ankle fracture
ARC WARFA BASIC & INSTRUCTOR TRAINING
WaRFA basic training is a 16-hour course which is open to youth, age 14 and above and adult Scouters.  Those youth and adults that demonstrate high levels of proficiency and motivation in becoming certified in First Aid, CPR and AED [FA/CPR/AED] and meeting age requirements [16+] may then enroll in a FA/CPR/AED Instructor-candidate training program.  The FA/CPR/AED instructor authorization is subsequently a prerequisite qualification to enrolling in a WaRFA Instructor-candidate Class.  Instructor-candidates are then intensively trained and familiarized with practical proficiency simulations and scenarios based on actual wilderness medical and trauma emergencies, using moulage and theatrical makeup to provide realistic and comprehensive evaluations.  The WaRFA instructor candidates then teach a WaRFA basic class under supervision of WaRFA Instructor-Trainers. Improvisation is a key element for WaRFA training, teaching students to creatively utilize what materials and resources they have with them to administer appropriate care for injuries and illness.  Instructor-candidates applying for the WaRFA Instructor training sign an agreement that they will voluntarily teach classes for the ARC and Scouting during the term of their authorization. Once authorized by the ARC, the WaRFA Instructors in Western Colorado Council have conducted basic classes in First Aid, CPR and AED as well as the WaRFA basic class for older Scouts, Venturers, Sea Scouts, Explorers and Scouters.  These classes are scheduled for the convenience of Scouts and Scouters at merit badge rallies and in an as-needed or on-demand basis for individual units when requested.  The cadre of Western Colorado Council WaRFA authorized Instructors are now planning to offer the WaRFA training in their own communities and at future summer camp sessions at SOAR.

WaRFA REQUIRED FOR NATIONAL HIGH ADVENTURE BASE TREK PARTICIPANTS
BSA policy now requires WaRFA certification for at least one member of any outdoor high adventure activity at a BSA National High Adventure Base such as Florida Sea Base, Northern Tier, Summit Bechtel National Scout Reserve and Philmont [two are required for Philmont crews].  It is strongly recommended that all participants, both youth and adult be similarly trained to deal with medical emergencies in isolated backcountry areas where medical response may be delayed for a considerable time.  WaRFA training should be considered as a high priority for all older youth and adults leading backcountry treks of any kind.



Sea Scout WaRFA instructor-candidates serve as "victims" and evaluators for WaRFA students
"… WHEN THE 'DOCTOR' NEEDS A DOCTOR ..."
BSA mandatory minimum training requirements for crews noted above will qualify crews for participation.  However, due diligence and risk management guidelines suggest that having multiple members of a crew, [including youth age 14+ who may be certified in WaRFA] is essential to the safety of the group, especially if the trained individuals themselves become injured or ill and need emergency care; or if the members of the group are inadvertently separated.  Redundancy is always best.

SIMULATIONS AND SCENARIOS ENHANCE LEARNING
A highlight of the Crew 9-1-1 Instructor training is moulaging of very realistic simulated injuries and coaching of "victim" actors to simulate illness to give students a very graphic understanding of signs and symptoms, and how victims behave.  Instructor Trainer and Associate Crew Advisor David Legaye specializes in "FX" or special effects with theatrical makeup and simulated blood, wound prosthetics and other simulations to create these realistic effects.

Advisor Jay Walker describes the simulations as similar to the grisly special effects in the movie, "Texas Chain Saw Massacre."

BACK COUNTRY COMMUNICATIONS SAVES LIVES - "The Golden Hour"
Victims of severe trauma or acute medical emergencies in the backcountry have the greatest probability of survival if they are delivered to a level 1 Trauma Center for definitive care in less than one hour from the onset of the emergency.  Emergency physicians call this "the golden hour."  Backcountry telecommunications devices can greatly increase the rapidity of a medical rescue response to a remote scene.

It is important to know that in everyday life, we are accustomed to being able to pick a wireless phone and dial 9-1-1 with an expectation that within a matter of minutes a paramedic first responder unit will arrive to deal with life-threatening trauma and medical emergencies.


Few realize that in remote areas, cell phones often will not function due to lack of cell tower availability and terrain.  Satellite phones, S.E.N.D. devices and two meter amateur radios used to rapidly communicate with a 9-1-1 PSAP to summon rescuers may provide a reliable alternative for a lack of cell phone coverage in backcountry areas.

SATELLITE PHONES AND 9-1-1 PSAP:
CALLING 9-1-1 ON A SATELLITE PHONE WILL NOT ROUTE YOUR CALL TO AN APPROPRIATE PSAP.

It will be necessary for your group to determine the ten-digit phone number for the 9-1-1 Public Safety Answering Point [PSAP] that serves the area where you will be located.  Contact local public safety officials [county sheriff, state patrol, national park service, et al] in that area and confirm the appropriate TEN DIGIT PHONE number[s] to call in the event that you have an emergency.  Also provide them with a map of the proposed trek area showing your routes and itineraries, where you will be camping each evening, and the dates, times, and start and finish points of your trek, where vehicles will be parked, etc.  Provide vehicle descriptions, license plate numbers, and persons not on your trek who are associated with your group at your home area that 9-1-1 PSAP or Mountain Rescue Groups may contact for background information.  Provide your satellite phone number [and cell phone numbers if they will operate in your trek area] in case they need to reach you during your trek.

See Scouting magazine Link:
scoutingmagazine.org/2016/02/how-to-choose-the-best-backcountry-communication-device-for-your-next-adventure

GPS
It is essential to carry a geosynchronous positioning satellite receiver [GPS] to transmit exact longitude and latitude coordinates to emergency 9-1-1 public safety answering point [PSAP]/communications centers.  You will need to know the ten digit number of the PSAP as dialing 9-1-1 on a satellite phone may not route your call to the correct center for emergency response.

AED
Carrying an automatic external defibrillator [AED] on backcountry treks can save lives since CPR along will not restore normal heartbeat if a sudden cardiac arrest [SCA] occurs.  Sudden cardiac arrest [SCA] is the leading cause of death in the nation killing more than 300,000 people of all ages annually.  For every minute the heart is in arrest, survivability decreases by 10 percent.  Average survivability of SCA victims is less than 7 percent.  Only rapid intervention with CPR and application of an AED can convert an abnormal heart rhythm and restore cardiac function.  Rapid evacuation of victims to hospitals is essential to save lives.

AED lightweight biphasic adult/pediatric high-capacity battery models suitable for rough handling, backpacking and wet environments with water tight cases recommended are Heart Sine 350p or Phillips FRX.  Philanthropic grants from foundations or service clubs may be available to fund purchase of AED units.

www.nhlbi.nih.gov/health/health-topics/topics/scda
scoutingmagazine.org/2016/02/how-to-get-trained-for-emergencies-in-the-wild

Moreover, the time it takes for a mountain rescue unit to be summoned and to access the site of the emergency may require many hours or in some cases, days particularly if weather is inclement and may preclude or delay aeromedical helicopters from being dispatched to the site.

SOAR Sea Scout Ship 30 Staff and WaRFA Instructors

Steve Fossett Spirit of Adventure Ranch in Western Colorado Council

[Photographs courtesy of Scouting Magazine photographic editor Garth Dowling and photographer Celin Serbo]



Bob Amick, WCC VP for Young Adult Programs, Ethan Davis, WCC Sea Scout Boatswain &
Cristian Joya WCC VOA President.  Cristian and Ethan are the key WaRFA youth Instructors in our program.

For more information, see the following websites:

Article provide by Robert D. Amick
Vice President for Young Adult Programs
Western Colorado Council